HomeMy WebLinkAboutResolution - 2006-R0510 - Offer Personal Accident Insurance To Employees - AIG Insurance Co. - 10_13_2006Resolution No. 2006-RO510
October 13, 2006
Item No. 6.9
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LLTBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and
directed to approve an offering for and on behalf of the City of Lubbock, personal
accident insurance on a voluntary basis to employees, by and between the City of
Lubbock and AIG Insurance Company, pursuant to the terms and conditions attached
hereto as Exhibit "A," within the amount budgeted for said coverage, offering the same
benefit as set forth in Exhibit "A" hereto, and in a final form and substance acceptable to
the City Manager and City Attorney.
THAT the City Manager or designee may execute any routine documents and
forms associated with said insurance coverage.
Passed by the City Council this 13th day of October , 2006.
DAVID A. ?I ILLER, MAYOR
ATTEST:
Rebe ca Garza, City Secretary
AP PRO D AS TO CONTENT:
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gs/ccdoes/AIG Ins Co. -offering personal accidcares
Oct. 9, 2006
Resolution No. 2006-RO510
October 13, 2006
"EXHIBIT A" Item No. 6.9
AIG - Domestic Accident & Health Division
8144 Walnut Hill Ln., Suite 1600
Dallas, TX 75231
Tele: 214-932-2336
Fax: 214-932-2342
October 2, 2006
Marta Alvarez
City of Lubbock
Purchasing Et Contract Management
1625 131h Street, Rm 204
Lubbock, TX 79401-3830
Re: Voluntary ADEtD Enhanced Plan for:
City of Lubbock
1625 131h Street
Lubbock, TX 79457
Underwritten by AIG Life Insurance
Dear Marta ,
AIG is pleased to provide you with a Voluntary Accidental Death Et Dismemberment quote for City of
Lubbock as provided under Group Accident Insurance Policy Form C11656TX(REV 3-99) as outlined
below:
Coverage:
An Insured and Eligible Spouse and Eligible Dependent Children) if enrolled in family plan, are
covered 24-hours a day, 365 days a year against covered accidents occurring in the course of business
or pleasure. Coverage is provided for Injuries caused by accidents that occur on or off the job, at
home, while traveling by plane, train, automobile, or any other public or private air, land or water
conveyance (except as limited by the EXCLUSIONS).
Description of Class:
Class 1: All active full-time employees of the Policyholder scheduled to work 40 hours or more
per week.
Class 2: All Eligible Spouse and Eligible Dependent Children) of Class 1 Insureds.
Eligible Spouse means the Insured's legal spouse.
Eligible Dependent Children means the Insured's unmarried children, including natural, step, foster
or adopted children from the moment of placement in the home of the Insured, under age 25 and
primarily dependent on the Insured for support and maintenance.
Any unmarried Eligible Dependent Children of the Insured covered under the Policy before reaching
the age limit specified above, who are incapable of self-sustaining employment by reason of mental
or physical incapacity, and who are primarily dependent on the Insured for support and maintenance,
may continue to be eligible under the Policy beyond that age limit for as long as the Policy is in
force, but only if they remain continuously covered under the Policy. The Company may request that
the Insured submit satisfactory proof of the Eligible Dependent Chitd(ren)'s incapacity and
dependency to the Company upon attainment of the age limit specified above. If the Insured fails to
furnish the requested proof, coverage for the Eligible Dependent Child(ren) will not be extended past
the age limit. If coverage is extended, the Company may request that the Insured submit
satisfactory proof of the Eligible Dependent. Child(ren)'s continued incapacity and dependency to the
Company on an annual basis.
Continuation of Eligibility. If premium payments are continued on a basis that precludes individual
selection, an Insured who ceases to be a member of any eligible class of persons as described above
may still be regarded as in an eligible class of persons as follows: (1) if the Insured is on temporary
lay-off or leave of absence (other than an authorized family or medical leave), for the full period of
the lay-off or leave, but not for more than three months in a row; or (2) if the Insured is absent from
work due to an authorized family or medical leave, for the full period of the leave, but not for more
than three months in a row unless a longer period is agreed to by the Company and the Policyholder.
The portion of premium payments paid by the Insured, if any, must continue to be paid during any
period of leave as described above for coverage to remain in force.
Principal Sum:
Class 1: 1, 2, or 3 times Annual Salary`, minimum $25,000 to a maximum amount of $300,000 in
increments of $25,000
Class 2: See the following Description
For an Insured Dependent Child. If an Insured Dependent Child suffers a loss for which a benefit is
payable under the Policy and there is an Insured Spouse on the date of the accident causing the
Loss, the Insured Dependent Child's Principal Sum is the lesser of $50,000 or 15% of the Insured's
Principal Sum on the date of the accident causing the loss. If there is no Insured Spouse on the date
of the accident causing the loss, the Insured Dependent Child's Principal Sum is the lesser of
$50,000 or 20% of the Insured's Principal Sum on the date of the accident causing the loss.
For an Insured Spouse. If an Insured Spouse suffers a loss for which a benefit is payable under the
Policy and there is an Insured Dependent Child on the date of the accident causing the loss, the
Insured Spouse's Principal Sum is 50% of the Insured's Principal Sum on the date of the accident
causing the loss. If there is no Insured Dependent Child on the date of the accident causing the
Loss, the Insured Spouse's Principal Sum is 60% of the Insured's Principal Sum on the date of the
accident causing the loss.
"'Annual. Salary" means the Insured's base annual salary exclusive of overtime, bonuses, tips,
commission, and special compensation.
Policy Form:
C11656TX(REV 3-99)
Benefits:
Form Number
Description
Applicable Class(es)
Accidental Death Benefit
1,2
Accidental Dismemberment Benefit
1,2
C11663DBG
Children's Additional Indemnity
2
C11664DBG
Coma Benefit
1,2
C11666(REV 3-99)
Common Disaster Benefit
2
C11667
Conversion
1,2
C11668(REV 3-99)
Day Care Benefit
2
C11671(REV 3-99)
Family Coverage
2
C11672
Family Extension
2
C11675(REV 3-99)
Felonious Assault Benefit
1
C11679
paralysis Benefit
1,2
C11683TX
Rehabilitation Benefit
1,2
C11687(REV 3-99)
Seat Belt and Air Bag Benefit
1,2
C11688(REV 3-99)
Tuition Benefit
2
AIG Assist
Endorsement:
C3008ODBG E-5 Injury Definition and Exclusions Amendatory Endorsement
Monthly Rates:
Class 1: Employee Only Coverage $.025/$1,000/Month
Class 2: Family Coverage $.038/$1,000/Month
Subject to minimum monthly premium of $100.00
Rates ore guoronteed for 36 months from the Policy Anniversary Dote
Commission Level:
Effective Date:
0%
January 1, 2007
Our quote is contingent upon the following:
■ Written Confirmation that coverage is accepted
Thank you for allowing AIG to quote this group. If you would like to discuss the quote or have any
questions, please feet free to call me at (214)932-2336.
Sincerely,
iD
Rose Zuniga
Underwriter
Domestic Accident & Health Division
This quote fetter provides a summary of the policy features only and does not cover all terms, conditions and
limitations. The policy will contain the actual terms, conditions and limits of the coverage to be provided. If there
is any conflict between this quote letter and policy, the policy will govern in all cases. Acceptance of this quote is
contingent upon and subject to the actual terms of the policy as issued.
Description of Benefits:
Accidental Death Benefit
If Injury to the Insured Person results in death within 365 days of the date of the accident that
caused the Injury, the Company will pay 100% of the Principal Sum.
Accidental Dismemberment Benefit
If Injury to the Insured Person results, within 365 days of the date of the accident that caused the
Injury, in any one of the Losses specified below, the Company wilt pay the percentage of the
Principal Sum shown below for that Loss:
For Loss of
Percentage of Principal Sum
Both Hands or Both Feet ....................................................
100%
Sight of Both Eyes............................................................
100%
One Hand and One Foot .....................................................
100%
One Hand and the Sight of One Eye .......................................
100%
One Foot and the Sight of One Eye ........................................
100%
Speech and Hearing in Both Ears ..........................................
100%
One Hand or One Foot .........................................................
50%
Sightof One Eye................................................................
50%
Speech or Hearing in Both Ears ..............................................
50%
Thumb and Index Finger of Same Hand .....................................
25%
"Loss" of a hand or foot means complete severance through or above the wrist or ankle joint. "Loss"
of sight of an eye means total and irrecoverable loss of the entire sight in that eye. "Loss" of
hearing in an ear means total and irrecoverable loss of the entire ability to hear in that ear. "Loss"
of speech means total and irrecoverable loss of the entire ability to speak. "Loss" of thumb and
index finger means complete severance through or above the metacarpophalangeal joint of both
digits.
If more than one Loss is sustained by an Insured Person as a result of the same accident, only one
amount, the largest, will be paid.
Injury - means bodily injury: (1) which is sustained as a direct result of an unintended, unanticipated
accident that is external to the body and that occurs while the injured person's coverage under the
Policy is in force, and (2) which directly (independent of sickness, disease, mental incapacity, bodily
infirmity or any other cause) causes a covered loss.
Exposure and Disappearance
If by reason of an accident occurring while an Insured Person's coverage is in force under the Policy,
the Insured Person is unavoidably exposed to the elements and as a result of such exposure suffers a
loss for which a benefit is otherwise payable under the Policy, the loss will be covered under the
terms of the Policy.
If the body of an Insured Person has not been found within one year of the disappearance, forced
Landing, stranding, sinking or wrecking of a conveyance in which the person was an occupant while
covered under the Policy, then it will be deemed, subject to all other terms and provisions of the
Policy, that the Insured Person has suffered accidental death within the meaning of the Policy.
Child(ren)'s Additional Indemnity for Dismemberment and Paralysis Benefit
The Company will pay a benefit under when an Insured has Family Coverage in effect under the
Policy and an Insured Dependent Child suffers an accidental dismemberment or an accidental
paralysis for which an Accidental Dismemberment benefit or a Paralysis benefit is payable under the
Policy. This benefit is payable to or on behalf of an Insured Dependent Child. It is payable with
respect to the one Benefit specified above which provides the larger benefit for all Injuries suffered
by the Insured Dependent Child in the same accident. The amount payable is an amount equal to the
amount payable under the Accidental Dismemberment Benefit or Paralysis Benefit, subject to a
maximum of $100,000.
Coma Benefit
If Injury renders an Insured Person Comatose within 90 days of the date of the accident that caused
the Injury, and if the Coma continues for a period of 30 consecutive days, the Company will pay a
monthly benefit of 1 % of the Principal Sum. No benefit is provided for the first 30 days of Coma.
The benefit is payable monthly as long as the Insured Person remains Comatose due to that Injury,
but ceases on the earliest of: (1) the date the Insured Person ceases to be Comatose due to that
Injury; (2) the date the Insured Person dies; or (3) the date the total amount of monthly Coma
benefits paid for all injuries caused by the same accident equals 100% of the Principal Sum. The
Company will pay benefits calculated at a rate of 1130th of the monthly benefit for each day for
which the Company is liable when the Insured Person is Comatose for less than a full month. Only
one benefit is provided for any one month of Coma, regardless of the number of Injuries causing the
Coma.
The Company reserves the right, at the end of the first 30 consecutive days of Coma and as often as
it may reasonably require thereafter, to determine, on the basis of all the facts and circumstances,
that the Insured Person is Comatose, including, but not limited to, requiring an independent medical
examination provided at the expense of the Company.
Coma/Comatose - means a profound state of unconsciousness from which the Insured Person cannot
be aroused to consciousness, even by powerful stimulation, as determined by a Physician.
Common Disaster Benefit
If an Insured with Family Coverage in effect under the Policy and his or her Insured Spouse both
suffer accidental death in the same accident within 90 days of the accident such that an Accidental
Death benefit is payable under the Policy for both persons, the Insured Spouse's Principal Sum is
increased to equal the lesser of: (1) $300,000; or (2) 100% of the Insured's Principal Sum.
Conversion Privilege
(Applies to the Accidental Death Benefit and Accidental Dismemberment Benefit only.)
If an Insured Person's coverage ends (prior to age 70) because he or she is no longer a member of any
eligible class of persons as described in the Classification of Eligible Persons section of the Master
Application, coverage may be converted to an individual accidental death and dismemberment policy
(herein called an Individual Policy). However, an Insured Dependent may convert only if he or she is
the age of majority or over on the date coverage ends.
The Company must receive a written application and payment of the required premium within 31
days after coverage ends under the Policy. No evidence of insurability is required to obtain the
Individual Policy. The Individual Policy will be a type the Company regularly makes available on its
effective date. The initial premium for the Individual Policy will be based on the Insured Person's
attained age, risk class, and amount of insurance provided, at the time of application for the
Individual Policy.
Coverage under the Individual Policy will take effect on the later of: (1) the date the application and
required premium payment are received by the Company; or (2) the date that the Insured Person's
coverage under the Policy ends. In the event that the application and required premium are not
received prior to termination of coverage under the Policy, coverage is not provided from the date
coverage ends under the Policy until the date coverage under the Individual Policy becomes
effective. Coverage under the Individual Policy may not be less than $100,000 and may not exceed
the greater of: (1) the amount for which the Insured Person was covered under the Policy; or (2)
$500,000.
Day Care Benefit
If an Insured suffers accidental death such that an Accidental Death benefit is payable under the
Policy and the Insured had Family Coverage in effect under the Policy on the date of the accident
causing death, the Company will pay a benefit on behalf of any Insured Dependent Child under age
13 who was insured under the Policy on the date of the accident causing death and who: (1) is
enrolled in a Day Care Center on the date of the Insured's death; or (2) enrolls in a Day Care Center
within 365 days after the Insured's death. The benefit is payable for each year of the Insured
Dependent Child's enrollment in a Day Care Center. The total amount of the benefit each year is
equal to the least of:
the actual cost of care for that Insured Dependent Child charged by that Day Care Center for
that year;
5% of the insured's Principal Sum on the date of the accident causing death; or
$5,000.
The applicable portion of the yearly benefit for each period of enrollment is payable upon receipt of
due proof of enrollment, but not more frequently than monthly.
The benefit is not payable for any period of enrollment in a Day Care Center before the date of the
accident that caused the Insured's death. The benefit is not payable for any period of enrollment
after the earlier of: (1) the date the Insured Dependent Child reaches 13 years of age; or (2) the
date four (4) years after the later of the date of the Insured's death or the date the insured
Dependent Child first enrolls in a Day Care Center.
Day Care Center - means a facility that is duly licensed, certified or accredited by the jurisdiction in
which it is located to provide child care and is operating in compliance with applicable laws and
regulations of the jurisdiction.
Family Extension Benefit
If an Insured suffers accidental death such that an Accidental Death benefit is payable under the
Policy and the Insured had Family Coverage in effect under the Policy on the date of the accident
causing death, coverage for his or her Insured Dependents who remained insured under the Policy
from the date of the accident to the date of death will be continued without premium payment.
Coverage will be continued until the earliest of:
the date following 12 months from the date of the Insured's death;
the date the Insured Dependent otherwise ceases to be a member of an eligible class of
persons as described in the Classification of Eligible Persons section of the Master Application;
or
the date the Policy ends.
In the event an Insured Dependent, whose coverage is being extended under the Family Extension
Benefit, suffers a loss for which a benefit is payable under the Policy, the Insured Dependent's
Principal Sum will be determined as of the date of the accident which caused the Insured's death.
Felonious Assault Benefit
(Percentage of Principal Sum Amount)
(Not Applicable to Insured Dependents)
The Company will pay a benefit under this Rider when the Insured Person suffers one or more losses
for which benefits are payable under the Accidental Death Benefit, Accidental Dismemberment
Benefit, Paralysis Benefit, Coma Benefit provided by the Policy as a result of a Felonious Assault:
1. that is directed at the Policyholder, its property or assets, or the Insured while he or she is
acting on behalf of the Policyholder as a member or representative; and
2. that is not a moving violation as defined under the applicable state motor vehicle laws; and
that is not an act of an Immediate Family Member, or an individual who resides with the
Insured Person on a permanent basis.
The amount payable under this Rider is 10% of the largest benefit payable under any one of the
Benefits specified above due to the assault. Only one benefit is payable under this Rider for alt
losses as a result of the same Felonious Assault.
Felonious Assault - means any willful or unlawful use of force upon the insured: (1) with the intent
to cause bodily injury to the Insured; and (2) that results in bodily harm to the Insured; and (3) that
is a felony or a misdemeanor in the jurisdiction in which it occurs.
Paralysis Benefit
If Injury to the Insured Person results, within 365 days of the date of the accident that caused the
injury, in any one of the types of paralysis specified below, the Company will pay the percentage of
the Principal Sum shown below for that type of paralysis:
Type of Paralysis Percentage of Principal Sum
Quadriplegia....................................... ......................... 100%
Paraplegia........................................................... ........ —10
Hemiplegia.................................................................... 100%
"Quadriplegia" means the complete ,and irreversible paralysis of both upper and both lower limbs.
"Paraplegia" means the complete and irreversible paralysis of both lower limbs. "Hemiplegia"
means the complete and irreversible paralysis of the upper and lower limbs of the same side of the
body. "Limb" means entire arm or entire leg.
If the Insured Person suffers more than one type of paralysis as a result of the same accident, only
one amount, the largest, will be paid.
Rehabilitation Benefit
If an Insured Person suffers an accidental dismemberment or an accidental paralysis for which an
Accidental Dismemberment or Paralysis benefit is payable under the Policy, the Company will
reimburse the Insured Person for Covered Rehabilitative Expenses that are due to the Injury causing
the dismemberment or paralysis. The Covered Rehabilitative Expenses must be incurred within two
years after the date of the accident causing that Injury, up to a maximum of $5,000 for all Injuries
caused by the same accident.
Hospital - means a facility that: (1) is operated according to law for the care and treatment of
injured people; (2) has organized facilities for diagnosis and surgery on its premises or in facilities
available to it on a prearranged basis; (3) has 24 hour nursing service by registered nurses (R.N.); and
(4) is supervised by one or more Physicians. A Hospital does not include: (1) a nursing, convalescent
or geriatric unit of a hospital when a patient is confined mainly to receive nursing care; (2) a facility
that is, other than incidentally, a rest home, nursing home, convalescent home or home for the
aged; nor does it include any ward, room, wing, or other section of the hospital that is used for such
purposes; or (3) any military or veterans hospital or soldiers home or any hospital contracted for or
operated by any national government or government agency for the treatment of members or ex -
members of the armed forces.
Medically Necessary Rehabilitative Training Service - means any medical service, medical supply,
medical treatment or Hospital confinement (or part of a Hospital confinement) that: (1) is essential
for physical rehabilitative training due to the Injury for which it is prescribed or performed; (2)
meets generally accepted standards of medical practice; and (3) is ordered by a Physician.
Covered Rehabilitative Expense(s) - means an expense that: (1) is charged for a Medically
Necessary Rehabilitative Training Service of the Insured Person performed under the care,
supervision or order of a Physician; (2) does not exceed the usual level of charges for similar
treatment, supplies or services in the locality where the expense is incurred (for a Hospital room and
board charge, does not exceed the most common charge for Hospital semi -private room and board in
the Hospital where the expense is incurred); and (3) does not include charges that would not have
been made if no insurance existed.
Exclusions. In addition to the Exclusions in the Exclusions section of the Policy, Covered
Rehabilitative Expenses do not include any expenses for or resulting from an Injury for which the
Insured Person is entitled to benefits paid or payable by Workers' Compensation or other similar law.
Seat Belt Benefit
The Company will pay a benefit under the Rider when the Insured Person suffers accidental death
such that an Accidental Death benefit is payable under the Policy and the accident causing death
occurs while the Insured Person is operating, or riding as a passenger in, an Automobile and wearing
a properly fastened, original, factory -installed seat belt or, if the Insured Person is a child, a
properly installed and fastened child restraint device as defined by state law. The amount payable
under the Rider is the lesser of: (1) $10,000; or (2) 10% of the Insured Person's Principal Sum.
Air Bag Benefit
The Company will pay an additional benefit under the Rider if a Seat Belt Benefit is payable under
the Rider and if the Insured Person is positioned in a seat protected by a properly functioning,
original, factory -installed Supplemental Restraint System that inflates on impact. The additional
amount payable under the Rider is the lesser of: (1) $5,000; or (2) 5% of the Insured Person's
Principal Sum.
Verification of the actual use of the seat belt, at the time of the accident, and that the
Supplemental Restraint System inflated properly upon impact must be a part of an official report of
the accident or be certified, in writing, by the investigating officer(s).
8
Automobile - means a self-propelled private passenger motor vehicle with four or more wheels
which is of a type both designed and required to be licensed for use on the highways of any state or
country. Automobile includes, but is not limited to, a sedan, station wagon, or jeep -type vehicle
and, if not used primarily for occupational, professional or business purposes, a motor vehicle of the
pickup, panel, van, camper or motor home type. Automobile does not include a mobile home or any
motor vehicle which is used in mass or public transit.
Supplemental Restraint System - means an air bag which inflates for added protection to the head
and chest areas.
Tuition Benefit
If an Insured suffers accidental death such that an Accidental Death benefit is payable under the
Policy, and the Insured had Family Coverage in effect under the Policy on the date of the accident
causing death, the Company will pay the following benefit:
A. For the Insured Dependent Children under Age 25. The Company will pay a benefit to or on
behalf of any Insured Dependent Child under age 25 who was insured under the Policy on the
date of the accident causing death and who, on the date of the Insured's death: (1) is a full-
time student in any Institution of Higher Learning above grade 12; or (2) is in grade 12 and
subsequently enrolls as a full-time student in an Institution of Higher Learning within 365 days
after the date of the Insured's death. The benefit will be paid for each year of the Insured
Dependent Child's continuous enrollment as a full-time student in an Institution of Higher
Learning, to a maximum of four (4) consecutive years. The total amount of the benefit each
year is equal to the least of:
1. the actual tuition (exclusive of room and board) charged by that institution for enrollment
during that year for that insured Dependent Child;
2. 5% of the Insured's Principal Sum on the date of the accident causing death; or
3. $5,000.
The applicable portion of the yearly benefit for each term of enrollment is payable upon
receipt of proof of enrollment for that term.
An Insured Dependent Child who ceases to be enrolled as a full-time student becomes
permanently ineligible for the benefit, even if he or she reenrolls at a later date. The benefit
is not payable for any term of enrollment as a full-time student that begins before the date of
the insured's death.
B. For the Insured Spouse. The Company will pay a benefit to or on behalf of any Insured
Spouse who was insured under the Policy on the date of the accident causing death and who,
for the purpose of obtaining an independent source of support or to enrich his or her ability to
earn a living: (1) is enrolled in any Institution of Higher Learning or professional or trade
training program on the date of the Insured's death; or (2) subsequently enrolls in an
Institution of Higher Learning or professional or trade training program within 30 months after
the date of the Insured's death. The benefit will be paid for each year of the Insured Spouse's
continuous enrollment in an Institution of Higher Learning or professional or trade training
program, to a maximum of four (4) consecutive years. The total amount of the benefit for all
institutions and programs combined each year is equal to the least of:
1. the total actual tuition (exclusive of room and board) charged by those institutions or
programs for enrollment during that year for the Insured Spouse;
2. 5% of the Insureds Principal Sum on the date of the accident causing death; or
3. $5,000.
The applicable portion of the yearly benefit for each term of enrollment is payable upon
receipt of proof of enrollment for that term.
An Insured Spouse who ceases to be enrolled as described above becomes permanently
ineligible for the benefit, even if he or she reenrolls at a later date. The benefit is not
payable for any term of enrollment that begins before the date of the Insured's death.
Institution of Higher Learning - means any accredited institution that provides education or training
beyond the 12th grade level, including, but not limited to, any state university, private college, or
trade school.
Reduction Schedule
The amount payable for a loss will be reduced if an Insured Person is age 70 or older on the date of
the accident causing the loss with respect to any Benefit provided by the Policy where the amount
payable for the loss is determined as a percentage of his or her Principal Sum. The amount payable
for the Insured Person's loss under that Benefit is a percentage of the amount that would otherwise
be payable, according to the following schedule:
AGE ON DATE OF ACCIDENT PERCENTAGE OF AMOUNT OTHERWISE PAYABLE
70-74 50%
75 and older 25%
Premium for an Insured Person age 70 or older is based on 100% of the coverage that would be in
effect if the Insured Person were under age 70.
"Age" as used above refers to the age of the Insured Person on the Insured Person's most recent
birthday, regardless of the actual time of birth.
Limitation on Multiple Benefits
If an Insured Person suffers one or more tosses -from the same accident for which amounts are
payable under more than one of the following Benefits provided by the Policy, the maximum amount
payable under all of the Benefits combined will not exceed the amount payable for one of those
losses, the largest: Accidental Death Benefit, Accidental Dismemberment Benefit, Paralysis Benefit,
Coma Benefit.
Exclusions
No coverage shall be provided under the Policy and no payment shall be made for any loss resulting
in whole or in part from, or contributed to by, or as a natural and probable consequence of any of
the following excluded risks even if the proximate or precipitating cause of the loss is an accidental
bodily Injury.
suicide or any attempt at suicide or intentionally self-inflicted Injury or any attempt at
intentionally self-inflicted Injury or auto -eroticism.
2. sickness, or disease, mental incapacity or bodily infirmity whether the loss results
directly or indirectly from any of these.
3. travel or flight in or on (including getting in or out of, or on or off of) any vehicle used
for aerial navigation, if the Insured Person is:
a. riding as a passenger in any aircraft not intended or licensed for the
transportation of ,passengers;
10
b. performing, learning to perform or instructing others to perform as a pilot or
crew member of any aircraft;
c. riding as a passenger in an aircraft owned, leased or operated by the
Policyholder or the Insured Person's employer.
4. declared or undeclared war, or any act of declared or undeclared war.
5. infections of any kind regardless of how contracted, except bacteria[ infections that
are directly caused by botulism, ptomaine poisoning or an accidental cut or wound
independent and in the absence of any underlying sickness, disease or condition
including but not limited to diabetes.
6. full-time active duty in the armed forces, National Guard or organized reserve corps of
any country or international authority. (Unearned premium for any period for which
the Insured Person is not covered due to his or her active duty status will be
refunded.) (Loss caused while on short-term National Guard or reserve duty for
regularly scheduled training purposes is not excluded.).
7. the Insured Person being under the influence of intoxicants while operating any
vehicle or means of transportation or conveyance.
B. the Insured Person being under the influence of drugs unless taken under the advice of
and as specified by a Physician.
9. the Insured Person's commission of or attempt to commit a crime.
10. the medical or surgical treatment of sickness, disease, mental incapacity or bodily
infirmity whether the loss results directly or indirectly from the treatment.
11. stroke or cerebrovascular accident or event; cardiovascular accident or event;
myocardial infarction or heart attack; coronary thrombosis; aneurysm..
AIG Assist
AMERICAN INTERNATIONAL ASSISTANCE SERVICES, INC., operating as AIG Assist provides a wide
array of services to our clients. These services are available 24-hours a day/7-days a week/365 days
a year (24/7). To better appreciate the complexity and range of these services, we have broken
them down into 4 broad categories - Information/General, Technical, Medical, tz Relocation - as
outlined below. These should serve as a broad description of the services we provide as an Assistance
company. However, AIG Assist customizes programs to meet the specific needs and requirements of
our clients. Our strength is in our flexibility to add, delete or customize specific services.
A. Information/ General:
1. Travel Documentation: AIG Assist advises international travelers on passport/visa requirements,
as well as customs entry/exit restrictions and regulations. Travelers are also advised where they
can obtain necessary travel documents.
2. Immunizations: AIG Assist advises travelers on required immunizations for their intended
destinations or points of transit. AIG Assist provides information on local medical advisories,
epidemics, etc., and provides information on available preventive measures.
3. Political/Environmental Warnings: AIG Assist keeps abreast of international conditions as
they relate to political and/or environmental situations and provides travelers with the latest
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updates. AIG Assist also provides information on US Government Offices abroad and how
to reach them, as well as Foreign Government Offices in the US.
4. Currency and ATM Locations: Currency exchange rates are available, as is information on
Local Bank/Government Holidays. ATM locations can easily be made available by
implementing our databases with this information.
5. Global Weather: General climate and up-to-date weather conditions are available for both
domestic and international destinations.
6. Emergency Message: AIG Assist takes, stores, and relays emergency messages to/from travelers
while they are traveling - both domestically and internationally. Messages may also be relayed to
an Internet e-mail address.
7. Telephone Translation: AIG Assist's multilingual staff can provide translations via telephone to
travelers who find themselves in an emergency travel situation where they do not speak the
language and cannot be understood.
B. Technical:
1. Lost/Stolen Luggage and Personal Effects: AIG Assist assists travelers who have had their
Luggage or personal effects lost or stolen. In the event of a loss, coordination between the
common carrier and delivery destination; shipment of replacement articles; and facilitation
of the claims process are some of the services we provide.
2. Lost/Stolen Travel Documents/Tickets: In the event a traveler's personal travel documents
are lost or stolen (passport, major credit cards, etc.), AIG Assist assists travelers obtaining
replacement and canceling original documents. AIG Assist can make alternate
reservations and arrange for replacement airline/rail tickets when needed.
3. Cash Transfer: In the event a client encounters unexpected situations while traveling depleting
their available cash, AIG Assist will arrange to send cash to them subject to provision of a
personal source of funds.
4. Vehicle Return: AIG Assist arranges for the return of rental vehicles in the event a traveler is
unable to continue driving due to illness, accident, etc. AIG Assist will pay the fees incurred up
to the limit on the insurance policy if applicable; uninsured fees or overages are collected from
the traveler.
5. Legal Referral: AIG Assist provides travelers with the name and contact information of a local
attorney should the need arise during a trip.
6. Trip Interruption: AIG Assist assists travelers who encounter en -route emergencies that force
them to interrupt their trips. This involves overnight hotel accommodations, alternate
transportation, and meals. AIG Assist can arrange to prepay such expenses on the travelers'
behalf.
C. Medical: These services are the most complicated of those offered and can last up to several
weeks. They involve AIG Assist's Medical Staff in addition to other network providers and often
include post -case payment/billing coordination on the traveler's behalf. They are as follows:
1. Physician/Dentist/Hospital Referral: AIG Assist provides travelers with contact information for
local Physicians, Dentists, and/or Hospitals/Clinics; AIG Assist will set up appointments, translate
if needed, and coordinate with the travelers' or travelers' primary medical insurance if the
information is available.
2. Medical Case Monitoring: AIG Assist's Medical Team follows the traveler's condition while
hospitalized away from home. This consists of telephone consultations with that person's on -site
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Physician, the Home Physician if beneficial, evaluation of medical data, and communication with
the traveler's family. AIG Assist' Medical Staff determines if the treatment is conforming to
typical Western standards and makes recommendations on alternate methods or locations„ if not.
3. Shipment of Medical Records and Prescription Medications: AIG Assist can arrange to have a
traveler's Medical Records shipped to the Treating Physician if this is required during a medical
emergency or, following treatment away from home, AIG Assist arranges for the medical records
to be shipped to the person's Home Physician. When allowed by local laws, AIG Assist will arrange
for the shipment of the traveler's prescription medication if this cannot be obtained locally.
4. Medical Evacuation: When the AIG Assist Medical Team determines that the client's condition
cannot be treated locally, all necessary arrangements are made to evacuate the patient to the
nearest adequate medical facility. Once stabilized and/or treated, AIG Assist continues with
arrangements to bring the traveler home.
AIG Assist can arrange the return of the patient's family when the traveler becomes ill or injured on
a trip, or arrange to a bring a designated companion to the patient's bedside in the event the person
is traveling alone when the illness or accident occurs.
5. Repatriation of Remains: AIG Assist makes all necessary arrangements for the return of a
traveler's mortal remains in the event of their death while on a trip away from home.
Coordination of local government restrictions and regulations as well as transportation needs are
handled.
6. Insurance/Claims Coordination: In the event of a medical emergency, AIG Assist works with the
traveler's insurance carriers and providers to coordinate billing of the medical expenses.
D. Relocation Services: A dedicated group of multi-lingual/multi-cultural coordinators (AIG
International Services) focuses on providing products and services to executives relocating to a
foreign land. In addition to traditional assistance services, coordinators focus on auxiliary products
and services that are critical to easing the tradition of the executive and their family on their new
international assignment. These products and services include locating schools and local utilities, as
well as marketing a variety of products including local currency credit cards, auto and homeowners
insurance, cross- cultural training and automobile leasing.
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